Abstract W P188: Cardiac Disorders in Patients with Stroke in Multiple Vascular Territories (MVT)
Stroke in multiple vascular territories can be defined as an imaging pattern of non-contiguous acute ischemic lesions in >1 vascular territory. Stroke in MVT has been reported with a number of medical disorders and may represent a pattern of injury at high risk of recurrent stroke. The goal of this study was to determine the frequency and etiology of cardiac abnormalities among patients who present with stroke in MVT.
Methods: The study population was derived from the NINDS LESION Study, a consecutive cohort of ischemic stroke patients (N=1193) admitted to two primary stroke centers (Washington Hospital Center, Washington, DC; Suburban Hospital, Bethesda, MD) between 01/1999 and 10/2009. All patients received an acute MRI (1 DWI +/ADC + MRI abnormality in multiple vascular territories (bilateral anterior, anterior-posterior, or all 3 regions). Cardiac studies (EKG, echocardiogram, and cardiac telemetry) on stroke admission were reviewed for each patient. The etiology and prevalence of cardiac abnormalities were determined for patients with stroke in MVT.
Results: Overall, 84 patients were included in the study, the median age was 69.5 yrs, 57% were African American, and 54% were female. Preadmission cardiac risk factors (AF, LVH, and CAD) were reported in 50% of patients. EKG abnormalities were identified in 76% of patients on admission. These included, HR abnormalities (tachy or bradycardia) in 51%, conduction disorders (AV or BB blocks) in 25%, and arrhythmias (supra or ventricular) in 25% of patients. Echocardiography abnormalities included; 61% with left ventricular abnormalities (hypertrophy, hypokinesis), 54% with left atrial enlargement, 37% with low EF (<50%), 27% with aortic arch abnormalities, 19% with mitral valve disorders (annular calcification, prolapse), and 7.3% with atrial septal defects.
Conclusion: EKG and echocardiography abnormalities are common in patients who present with stroke in MVT. An extensive cardiac evaluation is warranted to determine etiology and implement stroke prevention strategies.
Author Disclosures: D. Giannakidis: None. J. Shah: None. R. Benson: None. J. Lynch: None.
- © 2015 by American Heart Association, Inc.